Professional Documents
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80 70 60
Concentration
Concentration
0 0 10 20 30 40 50 60
50 40 30 20 10 0 0 2 4 6
Time ( hr)
Time
10
12
14
16
ENZYME INDUCTION
-Drug 2 enhances levels of p450 action/loss of Drug 1 1. Barbituates action of Coumadin & Digitoxin 2. Phenytoin action of Cortisol, Digitoxin, & Theophylline
ENZYME INHIBITION
-Drug 2 inhibits p450 metabolism of Drug 1 1. Cimetidine (gastric acid inhibitor) metabolism of Diazepam, Quinidine, etc 2. EtOH metabolism of Diazepam, etc.
0 0 10 20 30 40 50 60
Concentration
Time
DRUG-DRUG INTERACTION
May have opposing or synergistic effect Antagonistic Effects: Cholinergic & Adrenergics Addictive Effects: Much greater effect w/ 2 drugs Commonly, pt take unknowingly several different products containing the same NSAID (OTC Ibuprofen & Rx) risk of Adverse Effects Ex. Chloropromazine (antipsychotic) & Amitryptyline (antidepressant) results in excessive anticholinergic effects: a. Dry mouth, associated dental complications, blurref vision, Hyperpyrexia in pt exposed to temp & humidity Thiazide Diuretics ( BP) TGs, Blood Sugar; avoid if diabetic
PROTEIN BINDING
-If a drug is normally bound to plasma proteins (Albumin) drug interaction w/ receptor & drug transfer out of the vascular compartment -Drug 2 competitively binds to protein Drug 2 = 1 drug 1. Drug 1 (Tolbutamine) binds to protein (Albumin) 2. Drug 2 (Sulfonamide) competes for receptor 3. Transient [Drug 1]
1.
2.